Irritable bowel syndrome

What is IBS?
Irritable Bowel Syndrome (IBS) is a common, chronic disorder affecting the large intestine (colon). It causes cramping, abdominal pain, bloating, gas, and changes in bowel habits (diarrhea or constipation).

Unlike Inflammatory Bowel Disease (IBD) such as Crohn's or Colitis, IBS does not cause changes in bowel tissue or increase your risk of colorectal cancer. It is a functional disorder, meaning the bowel looks normal but doesn't work normally.

Symptoms

Symptoms vary widely and often resemble other diseases. The most common include:

• Abdominal pain or cramping (often relieved by passing stool).
• A bloated feeling and Gas.
• Diarrhea (IBS-D).
• Constipation (IBS-C).
• Alternating bouts of constipation and diarrhea (IBS-M).
• Mucus in the stool.

⚠️ RED FLAG SYMPTOMS
IBS does not typically cause the following. If you experience these, see a doctor immediately to rule out serious conditions like Colon Cancer or IBD:

• Rectal bleeding.
• Abdominal pain that occurs at night or wakes you up.
• Unexplained weight loss.
• Iron deficiency anemia.
• Persistent vomiting.

Causes & Triggers

The exact cause is unknown, but it involves the muscles in the intestine contracting too strongly (causing diarrhea) or too weakly (causing constipation). Triggers include:

• Foods: Chocolate, spices, fats, beans, cabbage, milk, and alcohol.
• Stress: Symptoms often worsen during finals week, job changes, or emotional trauma.
• Hormones: Women are twice as likely to have IBS; symptoms often worsen during menstrual periods.
• Gastroenteritis: A severe stomach infection can sometimes trigger long-term IBS.

Diagnosis

There is no specific test for IBS. Diagnosis is based on ruling out other problems and meeting specific criteria (Rome Criteria):

• Recurrent abdominal pain (at least 1 day/week for 3 months).
• Pain related to defecation.
• Change in frequency or appearance of stool.

Tests to Rule Out Other Conditions

• Lactose Intolerance Test: To ensure dairy isn't the cause.
• Breath Tests: To check for Bacterial Overgrowth (SIBO).
• Blood Tests: To screen for Celiac Disease (Gluten intolerance).
• Colonoscopy: Used for patients over 50 or those with red flag symptoms.

Treatment

Treatment focuses on relieving symptoms so you can live normally.

1. Dietary Changes

[Image of low FODMAP foods chart]

• Eliminate High-Gas Foods: Carbonated drinks, cabbage, broccoli, and raw fruits.
• FODMAP Diet: Many patients find relief by eliminating specific carbohydrates (FODMAPs) found in grains, vegetables, and dairy, then reintroducing them one by one.
• Gluten-Free: Some IBS patients improve when stopping wheat, barley, and rye.

2. Medications

• Fiber Supplements: Psyllium (Metamucil) to help control constipation.
• Anti-diarrheal: Loperamide (Imodium) to control diarrhea.
• Antispasmodics: Hyoscyamine (Levsin) or Dicyclomine (Bentyl) to relieve painful bowel spasms.
• Antidepressants: Tricyclic antidepressants or SSRIs can inhibit the neurons that control intestinal pain.
• Specific IBS Drugs: Alosetron (Lotronex) for severe diarrhea in women, or Lubiprostone (Amitiza) for severe constipation.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.